A therapy with which kidney patients can lead a more active and independent life, without constantly visiting hospitals or care centers.
Science and technology are advancing rapidly, achieving even more independence in treating various health problems. On the list is home dialysis, also known as peritoneal dialysis, with which kidney patients can carry out their treatment without constantly going to a clinic or medical center. What is? How does it help the kidney patient? Alejandra Patricia Molano, Baxter RCS nephrologist, answers these and many other questions related to the topic.
What is home dialysis?
Home dialysis therapies are alternatives for patients to self-administer their treatment. It can be home hemodialysis (although it is not available in our country) and peritoneal dialysis (PD). In this sense, PD is a replacement therapy for kidney function in which the peritoneum (membrane that covers the intestines) is used to cleanse the blood of toxins that accumulate in kidney failure.
How is this treatment done at home? What steps should patients with CKD follow?
To perform PD, a catheter (plastic tube) is required that is implanted in the abdomen, through which a special liquid (dialysis) is administered to carry out the exchange of substances. That fluid is left in the abdomen for a few hours and then it is drained and a fresh one is infused. It can be done with a machine called a cycler, which is used at night while the patient sleeps, or with bags manually 3 or 4 times a day.
How should a patient prepare for dialysis at home?
It is requested to have a clean area in the home for your connection, without drafts (such as open windows or doors) and with drinking water at hand, ideally from a sink. A small table (or a table made of a material that can be washed) is also required to support the dialysis materials, and it is recommended to have a place to store the monthly bags away from strong odors or heat sources.
What changes will the kidney patient have to make, in their habits and more, when starting dialysis at home?
In general, a person with kidney disease who needs to start dialysis should make changes to their diet (low in potassium, phosphorus, and fluids), should follow the recommendations of the nephrology office regarding medications, and should dialyze with the doses and given guidelines. In the case of peritoneal dialysis patients, daily bathing, catheter care, use of laxatives, and adherence to techniques to connect to therapy are recommended.
What are the benefits of a treatment like home dialysis?
For many people, home dialysis means more freedom to do routine activities like work, school, or travel.
It is cheaper for families with dialysis patients to perform PD than clinic therapies, since they do not have to pay for transportation to the renal unit, they only have to attend the monthly consultation. This is especially important for those who live far from clinics or who have difficulty getting around.
Some studies suggest that patients on home dialysis have a better quality of life and fewer symptoms of the disease than those on hemodialysis.
Those who do dialysis at home usually have more time available to share with their family, to do activities that keep them busy and productive, and this affects their vitality and perception of well-being.
Is home dialysis recommended for any kidney patient? There are exceptions?
Almost all patients can do PD. Difficulties only exist in those with a history of abdominal surgeries, severe peritonitis, very large hernias that cannot be operated on or people who do not have the possibility of connecting safely at home, such as blind patients without family support, and those who have hand problems such as arthritis or tremors that do not have an aid. People must be evaluated to individually define whether or not they are candidates for therapy.
How does the home dialysis service offered by Baxter RCS work?
The patients are followed up monthly by a group of nutrition, social work, nursing psychology and nephrology, in a consultation with exams taken in the renal clinic and with pharmacy availability for the drugs involved in dialysis therapy. Supplies such as the machine, liquids and cleaning supplies for the connection (soap and hand towels) are delivered to their homes without transportation costs, even in distant areas.
Despite not being in a care center, will the Baxter RCS patient always have the support of specialists? How is the communication between both parties?
Communication with the dialysis unit is done through conventional channels such as telephone or email. In terms of dialysis, modern machines (cyclers) have an internet system that transmits therapy information and gives alarms in case of problems. All this is received by nurses and doctors.
Are both the home accompaniment and the care service in Baxter RCS care centers offered throughout the country?
Yes. Even in cases of transitory transfers such as vacation periods, nephrology monitoring can be carried out in the main cities of Colombia and dialysis throughout the country. Supplies are delivered by a courier service that makes distribution to most locations possible.
What is the difference between dialysis at home (peritoneal) and dialysis at Baxter RCS Care Centers (hemodialysis)?
Hemodialysis is done three times a week in sessions of four hours on average in the renal clinic, with a special machine and filter that cleans the person's blood directly, so a catheter or a fistula in the veins of the kidney is needed. patient's arm to draw and return blood during therapy. On average, you have to go to the clinic 12 times a month.
Peritoneal dialysis does not involve blood, it uses fluid inserted into the peritoneal cavity in the abdomen through a catheter. The liquid that leaves the patient's body has toxins from kidney failure, but it is not blood or urine and is eliminated in the bathroom at home. It is done every day at home. The patient only comes to the clinic for the monthly medical appointment.